i use to be on viracept and epiver and zerit for 5 years.for the last 3 years i have been drug free. my viral load was undetectable for many years. just recently my doctor checked for hepc @found out i have it. millions he said the viral load is / he said for hepc it was average. my hiv viral load is and has been arounnd 10,000 for maybe one and a half years. my doctor wants to put me on viramune i am afraid because my liver enzymes have started to jump. is this the best choice? and what should i start first? the hiv therapy or the hepc ?i have been positive for 16 yearswithoutany oppurtunistic diseases but i know i have had hep c longerlike 25 years . i am mad at my doctor for not checking my hepc back when my liver was healthy. my husband and son are both negative for everything. and i work full time. please help me decide , my t/cell count is around 225 and because the majority of my docs patients are homosexual malesi don"t think he always knows whats right for me iam 46 years old without any other health problems.

Response from Dr. Dieterich

Good question. Viramune is more likely to be liver toxic in women if your CD4 count is over 350. Every drug has slightly higher risk in HCV positive patients. Since your t cells are low, I would go ahead with the HIV medication first. After monitoring your liver every 2 weeks for 8 weeks, then you can start the HCV medication. The HIV viral load is low, but the CD4 cells are also low so I would go with the HIV treatment first. Good luck! DTD

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